Remember how Raya fell off of a chair Monday night & hurt her shoulder? Turns out it wasn't really her shoulder. Appointment #6 of 7 for the week revealed this:
Small buckle fracture of the proximal humerus. Oops. In my defense, the girl has a serious lack of appropriate pain response. She's been favoring it a little bit this week but it has seemed to improve over the last couple days, especially after one of the OTs did some myofascial release on her shoulder on Wednesday. On Tuesday when I had her at the specialty clinic for her weight check, I scheduled an appointment with the orthopedic doctor for today since we already had a full schedule on Wednesday & they only do ortho on Monday, Wednesday & Friday. Wednesday, I had planned on taking her to the urgent care in the evening to get it x-rayed but she seemed to be feeling better & was moving it a lot more so at that point I thought she probably hadn't broken anything or she would have still been more guarded with it. Lesson learned. Next time Raya falls off something, we will go to urgent care the same night.
Fortunately since she has such a high pain tolerance and we didn't know yet that her arm was broken, we were still able to do OT right before the ortho appointment this morning. Her therapist was out of town for the last 2 Fridays in a row so the only OT she's had in the last 2 weeks was pool therapy. When she misses an appointment or two, we can really see how much OT helps her. :)
It's kind of hard to explain the difference it makes, but one thing we notice is that she is SO easily distracted and so much more likely to avoid doing things that are difficult or uncomfortable for her when she's not going to OT. She has had absolutely zero attention span this past week. Normally when we talk to her, she acknowledges it and responds (as much as a typical toddler would :) but when she's missing OT, talking to her is like talking to a brick wall. One of her coping mechanisms is to distract herself from things that are unpleasant or difficult for her, and for some reason OT seems to help reduce her need to do that.
Anyway, she had a really good and much needed OT session today. Kaida played at a friend's house so it was just Raya, and it's harder to get her to do a lot of things at therapy when Kaida isn't there. Most of the time it's good to have Kaida there but it's also good once in a while for Raya to have to do things because she decides to on her own, not because she's doing it to be like Kaida. The place she does OT at has goats and they got a new goat this week. Kaida was kind of excited about it and had to stop & talk to the goat on her way out to the barn:
And by the way, I'm just a *teensy* bit excited about that little bitty twiggy ponytail on the top of her head. I've been waiting forEVER for her to get enough hair to do that with. :) Today was the first time she's kept it in.
We went in the barn to play in the ball pit, which used to be HORRIBLE for her. It took many, many tries to get her to go in the ball pit without crying and freaking out. Now she'll get in it okay but moving in there is hard for her and it's still a bit of a stretch for her sensory-wise. Today, Elizabeth would have her drop a heavy ball in the ball pit and then she'd drop Raya into the ball pit, have her find the heavy ball & get it out of the ball pit, and then we'd help her climb out. After that, she'd carry the ball to the other side of the room, play with a little shape puzzle, and then carry the ball back to the ball pit & do it all over again.
Due to the aforementioned broken arm (which we still didn't know about during OT), she had a harder time getting to the side of the ball pit & climbing out but she did pretty darn good considering that she wasn't really able to use her right arm to help pull herself out.
When we were done with the ball pit, there were a couple other little girls having their therapy and the therapists decided to turn on the inflatable bouncy thing. Raya freaked out when they turned it on and wanted NOTHING to do with bouncing on it.
She wanted OFF of that thing NOW! One of the other little girls got on it with her and she wasn't too excited about it either, so the two therapists sat with the girls in front of them and had them toss a ball back & forth. It was comical. Neither one of the girls really wanted to do it and they kind of took turns crying about it. :)
Then the third therapist tried to get her little patient to jump on it too and she was even less happy about it than Raya & the other little girl, so there were 3 girls on this bouncy thing and there were at least 2 of them crying the whole time. Bless their hearts, it is so sad to see a little kid have such a hard time processing & coping with something that most kids would think was fun.
Before Raya started OT, I knew that OT was good for things like recovering from brain injuries & things like that but I really didn't understand why little kids need it and what good it can do for a child with sensory processing disorder. Raya has been seeing Elizabeth for just over a year now and she is a completely different kid than she was then. (we just found out Elizabeth is moving *sniff sniff* and we're in denial & trying not to think about her leaving)
Not only has the OT helped with her sensory issues, but BECAUSE of the improvement with her sensory issues, she has been able to benefit so much more from her physical therapy and feeding therapy because she has been able to tolerate those so much better. I think we are so much farther ahead of where we would have been with both her PT and her feeding than we would have been without OT.
After OT we went straight to the ortho appointment. This was the point at which Raya officially ran out of good waiting room behavior. She has spent SO much time at that clinic that she's usually really good in the waiting room. She honestly thinks she owns the place. :) Today was a different story though. Ortho was her 6th appointment for the week and she was just done. I was holding her when we walked in and she kicked & screamed and wanted down so I put her down and checked in. Then when I went looking for her, she was looking at a baby in a carseat. I got her hooked up to her feeding pump and then she started climbing all over the waiting room furniture like a wild monkey. Then she fell off and landed on her hurt arm like she's been doing all week, which made me look like a terrible mother. It was at that point when I went to pick my crying child up and EVERYBODY in the waiting room had turned to look at us that I realized we had become "those" people. You know, the mom who lets her wild, out of control kid run all over the waiting room & climb on the furniture & touch other people's carseats & diaper bags. I finally explained to one mom (who kept telling her not to touch her son's carseat, which she wasn't really touching anyway) that it was Raya's 6th appointment of the week and she had just run out of patience for being in waiting rooms. Luckily the nurse came & called us back at that point so at least we were contained to a smaller room. :)
After a couple minutes they took us in to get the x-rays and then we went back to our room to wait. The PA came in to look at the x-ray and showed me where the break was. You could see it on both views but I only took a picture of the one where you could see it best.
They said that it's too high up on her arm to cast it so all they could do was put it in a sling. I laughed. We tried that in November when she broke her arm the first time and it was a joke trying to keep her arm IN the sling. The sling they gave us this time is a nicer one though and I think it will work better than the other one. They said if her arm wouldn't stay in it to wrap her with an ace bandage to keep it down so that's what we ended up having to do. The problem is that now, every time she falls down (which is frequently) she instinctively puts her arms out to catch herself and since that's how the break happened to begin with, she hurts it more, so for now we need her arm to be held down so she doesn't end up making the fracture worse. We'll go back in 2 weeks for a follow-up x-ray to make sure it's healing, and since we'll be there anyway, we'll also do a weight check to see if the increase in calories is getting her back on track with weight gain.
After that, we had a lovely lunch with my friend who kept Kaida for me and then went home to wait for the PT to come. Raya was SO tired and crabby by then because she hasn't had a good nap schedule the whole week. I tried to get her to lay down on the couch for a while but that never really works with her. :)
Surprisingly, she still ended up having a good PT session. She did the stairs really well a couple times but then got fatigued & couldn't make it up all the way the last time without getting really wobbly on her weaker leg. She was really distracted when Jessica was trying to do a lot of things with her but she did well with the things she actually did. :)
Having PT this afternoon broke our previous record of 6 appointments in one week. We've done 6 in a week a few times before but this was our first time doing 7. I'm SO glad we don't have weeks like this very often anymore and SO ready for the weekend!
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